The first wave of worksite wellness programs could be rudimentary and demand little from participants. Companies might lay out healthier snacks at meetings or offer workers a small gift just for calling a wellness counselor.

But as the popularity of these programs grew, business owners wanted to ensure they could increase staff participation and get more bang for their buck.

Now, business is moving from the beta stage of wellness to version 2.0, going beyond just posting benefit notices on the employee bulletin board to incorporating interactive social-media messaging.

It requires employees to actually become healthier, rather than just saying they will, but it can reward them with prizes like free health insurance.

And it goes beyond shedding a few pounds to incorporate much deeper indicators of both physical and mental health.

“Worksite wellness is not like doing pushups. Anybody can do pushups. Worksite wellness can be complicated,” said Scott Poston, the fitness director at the Denver Athletic Club who leads monthly worksite wellness seminars with businesses throughout downtown. “Worksite wellness isn’t just about having fruit at the secretary’s desk ... It’s more about productivity and relationships and networking.”

The first rule of worksite wellness, everyone involved agrees, is that there is no silver-bullet program that guarantees employees will want to become healthier and will lose weight or bring down their cholesterol.

But there is one sure-fire way of failing at improving worker health: instituting wellness programs without soliciting input from employees and without getting buy-in that they will take enough ownership in the program to go beyond superficial participation levels.

Poston said what’s needed is a commitment that actually makes employees healthier. He cited as an example one company that bought thousands of dollars of B-cycle memberships for employees without gauging interest in the bicycle-sharing program.

The company became disillusioned with wellness, when it was just that particular approach that didn’t work.

One way companies can get workers more involved is to offer rewards — not just gift certificates to restaurants that may or may not serve healthy food, but real, tangible benefits that make a difference in employees’ pocketbooks.

For example, take DaVita Inc.’s “We Are Well” program.

The Denver kidney-care giant, which began offering wellness programs about four years ago, now gives “vitality points” to participants that can be used to bring down their health insurance premiums.

The biggest prize, awarded this year to 44 employees who submitted stories about how their wellness efforts have caused them to make major lifestyle changes, is one year of free health insurance — a prize that cumulatively could cost the company around $40,000 this year.

While DaVita may be pushing the envelope on rewards for healthy behavior, it also is one of the small but growing number of companies that reward outcomes that prove increased wellness rather than rewarding simple participation, said Cas­ey Scott, the company’s wellness manager.

To receive vitality points, employees have to participate in biometric screenings for things such as glucose and cholesterol levels, and their results have to be at least at national standards for target health, she said.

The bigger picture for the company is not just having healthier employees but keeping down the amount it spends on health care each year.

Its goal is to keep health care spending from rising no more than 4 percent — a significantly lower hike than the national average, Scott said.

“We look at it in the aggregate. And we do see our risk factors getting better,” she said of improvements in employees’ weight and blood pressure. “From year to year, the percentage of our teammates with risks are going down.”

Better employee health is linked to fewer sick days and higher productivity. Studies have shown that for every dollar spent on worksite wellness programs, the return can be $3.27 over time, said Michelle Lueck, president/CEO of the Colorado Health Institute.

But because such efforts help to stave off long-term chronic diseases like diabetes or heart disease before they begin, investment return is not immediately noticeable on balance sheets, Lueck warned. As such, it’s been harder at times to convince companies to undertake spending on such programs while they are trying to figure out how to cut their budgets, she said.

Some insurers, which realize better than most other companies the rising cost of health care, are offering incentives to companies to institute such programs.

UnitedHealthcare, for example, rolled out a program in April that provides biometric screening kits to employees at smaller firms and offers client employees $20 a month if they sign up at fitness centers — and go to them at least 12 times a month, explained spokesman Will Shanley.

In addition to providing financial gain for workers, employers also need to make it convenient for employees to participate in wellness programs. IncentaHEALTH LLC, a Denver company that works with businesses to facilitate wellness programs, has begun communicating to employees in the ways that they communicate in their daily lives.

IncentaHEALTH, for example, sends text messages around lunchtime to people to remind them to eat healthy; 40 percent of the people the company communicates with have opted into this program, said Todd McGuire, chief technology officer.

It also keeps track of clients’ weight loss and offers them an increasingly popular option to download such results to Facebook and brag about their loss, he said.

“For corporate wellness programs that have been around for a while, a lot of time they just suffer from a lack of participation,” McGuire said. “When we turned this [Facebook application] on, people started using it.”

Professionals get onboard

Leaders of Porter Adventist Hospital in Denver saw the wave of wellness programs several years ago, looked at their own staff and realized that, for the most part, they were physically healthy, said Dr. Dianne McCallister, chief medical officer.

But with mental burnout being a serious problem for overworked physicians, they asked if there was something more they could do.

So Porter instituted a program where groups of about 60 doctors get together for monthly meetings in which they talk about both professional issues and ways to separate their professional and personal lives.

They offer a weekly email reflection in which participants must question how they are doing.

And they offer group activities in which families are invited after hours — activities that McCallister referred to as support groups that don’t quite rise to the level of therapy.

Dr. Simeon Abramson, a thoracic radiologist who has been participating in the program for almost three years, said mental health is the forgotten part of wellness.

But the unique program has done so well in helping participants that hospital leaders have begun discussing ways to disseminate it beyond the walls of Porter, he said.

“It’s great if you exercise every day and it’s great if you do yoga, but ... if you come in one day and emotionally you’re checked out because something else is going on in your life, then you’re probably not doing a good service to yourself or the people you take care of,” Abramson said.